Should Your Keep Going to PT Even if You Aren't Getting Better? (2024)

I once evaluated a patient who was dealing with low back pain and sciatica. He states he had pain in his leg for quite some time, and it got significantly worse about 6 months ago. His doctor at the time sent him to physical therapy with a diagnosis of hip bursitis, and the patient reports he did a lot of stretching in physical therapy with no significant relief.

Should Your Keep Going to PT Even if You Aren't Getting Better? (1)

The patient finally saw an orthopedic surgeon, and lumbar surgery was performed on his low back to relieve pressure on his sciatic nerve from a herniated disc. My patient reported initial relief from the surgery, but he continues with leg pain and abnormal sensation, so his doctor referred him to physical therapy once again to manage the post-operative recovery.

While talking with my patient, I asked him how long he spent in physical therapy. He told me he went to 20 sessions of physical therapy. I was surprised. My patient told me that the physical therapy never made him feel better, and in fact occasionally he left feeling worse.

I asked him why he went for 20 sessions if he was getting no relief. He replied that he went until his insurance company wouldn't pay any longer, and then he was discharged.

Now, why would anyone continue with a treatment that wasn't too successful until insurance wouldn't pay? A more important question: Why would a physical therapist treat a patient unsuccessfully for 20 sessions and then discontinue therapy once insurance ran out? Shouldn't your physical therapist be making clinical decisions?

Look, I know that all physical therapists (and other healthcare professionals) practice within strict confines of insurance regulations, and sometimes these regulations seem unfair. But to have a patient continue on a course of treatment that offered no relief and very little progress seems a bit unfair...to the insurance company.

Every condition is differentand that everyone heals at different rates. In my opinion, if you are not making progress in a reasonable amount of time, your physical therapist should refer you on to a more appropriate treatment. If you are progressing and making gains in range of motion, strength, and function, surely continue along. If not, ask your physical therapist if you should be continuing in PT. A good physical therapist knows what he or she can treat. A great physical therapist knows his or her limitations.

How Long Should Your PT Episode Last?

So how long should physical therapy take? Should you stop PT just because your insurance company won't pay?

In general, you should attend physical therapy until you reach your PT goals or until your therapist—and you—decide that your condition is severe enough that your goals need to be re-evaluated. Typically, it takes about 6 to 8 weeks for soft tissue to heal, so your course of PT maylast about that long. Of course, if you have a serious condition or a progressively worsening condition, your course of rehab may take longer.

A Word From Verywell

When you are referred to a physical therapist, it is nice to know what you are getting into. Will your therapy last for one or two weeks, or will you require several weeks or months of rehab to get better? This question is best answered by you and your PT, working as a therapeutic alliance to help you move better and feel better.Your PT should help you decide when to stop rehab. The decisionshouldn't be based on how much reimbursem*nt is offered by your insurance company.

2 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Bailey CS, Rasoulinejad P, Taylor D, et al. Surgery versus conservative care for persistent sciatica lasting 4 to 12 months.N Engl J Med. 2020;382(12):1093-1102. doi: 10.1056/NEJMoa1912658
Halfon P, Eggli Y, Morel Y, Taffé P. The effect of patient, provider and financing regulations on the intensity of ambulatory physical therapy episodes: a multilevel analysis based on routinely available data. BMC Health Serv Res. 2015;15:52. doi:10.1186/s12913-015-0686-6

FAQs

Should Your Keep Going to PT Even if You Aren't Getting Better? ›

Generally speaking, you should not stop physical therapy until you've reached your goals or unless your condition is not improving and your physical therapist determines that you would be better served by another treatment method. If physical therapy is too painful, you may need medical treatment.

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When should I stop going to physical therapy? ›

#1: You've Reached Your Goals

Maybe you'll be satisfied once your pain is gone? Your physical therapy plan will be developed based on these goals. Once you and your therapist are satisfied with your success in terms of the goals you decided upon at the beginning of your program, it's time to move on.

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What to do if physical therapy isn't helping? ›

Seek a second opinion

Discussing your concerns with your physician can be a good place to start, but even asking another physical therapist can go a long way. Remember that every therapist has their own unique set of skills and experiences, and what works for one person may not work for another.

Should I continue physical therapy if it hurts? ›

Physical therapy should never cause true pain

The point at which you begin to experience real pain is the point at which you should stop your PT regimen and consult with your therapist. Your regimen may require modification in order to achieve your goals without creating pain or causing further damage.

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Why isn't my back getting better with physical therapy? ›

Spinal instability, caused by spinal ligament laxity can cause vertebrae to move out of their natural positions and cause bulging and herniation. Even a single maligned vertebrae can impact and cause dysfunction throughout the spine and core muscle groups. This will make physical therapy ineffective.

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When should you stop seeing a PT? ›

You're Not Seeing Progress

There are times when you may do PT for a few weeks (or months) and see no progress toward your goals. At this point, it may be wise to consider stopping PT.

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How long is too long for physical therapy? ›

In general, you should attend physical therapy until you reach your PT goals or until your therapist—and you—decide that your condition is severe enough that your goals need to be re-evaluated. Typically, it takes about 6 to 8 weeks for soft tissue to heal, so your course of PT may last about that long.

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How do you know physical therapy isn't working? ›

If there's no change to the area of pain or discomfort within two weeks of physical therapy, this might need to be a referral back to a physician. This assumes that the patient has fully participated in their treatment, and the PT is also doing their role.

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What is the next step if therapy doesn't work? ›

What do you do when therapy isn't working? Consider what could be done differently in order to get better results. It may be beneficial to try different approaches such as medication management, lifestyle changes, or alternative therapies like yoga or mindfulness meditation.

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Should you take a break from physical therapy? ›

If you're experiencing excessive soreness or fatigue, take it easy and allow yourself to recover for the next session. Remember that the progress is being made on the days when you're resting. That being said, we advise that you take an active rest, if at all possible.

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Should I push through pain in physical therapy? ›

Pain is an indicator that something is amiss.

It may indicate overuse, a substitution pattern of muscle activity or poor joint mechanics. Pain can be described as “sharp” or “stabbing”, and can be present in muscles or joints. Despite what you may have heard, “Playing through pain” is a bad idea.

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What is the average number of visits for physical therapy? ›

On average, it can take around a few weeks to a few months to complete physical therapy treatment depending on severity and how consistent you are in your care. On average patients see their PT for about 10-12 visits, and you continue your exercises after physical therapy appointments are done.

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How long do most people stay in physical therapy? ›

On average, it can take around a few weeks to a few months to complete physical therapy treatment depending on severity and how consistent you are in your care. On average patients see their PT for about 10-12 visits, and you continue your exercises after physical therapy appointments are done.

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Why do patients quit physical therapy? ›

The two main reasons to stop physical therapy include goals not being met and lack of progress. When goals are not reached — Typically, at the beginning of a physical therapy plan, the therapist will help individuals set goals, such as a reduction in pain or the ability to participate in certain activities.

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Can too much physical therapy be harmful? ›

Yes, it is possible to do too much physical therapy. Therapy must be done in moderation. If you exceed the instructions that your therapist gives, you could cause further damage and even reverse the effects of your therapy. Your treatment is designed to help you build strength, increase mobility, and recover over time.